Department of Biochemistry
University of Jos

Clinical Demonstration

NAME: Mrs G.H.

Age: 38 years

Sex: Female

OCCUPATION: Housewife

 

PRESENT HISTORY:
Polyuria  ( 6 months)

Polydipsia ( 6months)

Polyphagia (6 months)

Loss of weight (6 months)

Paresthesias over hands and feet (6 months)

Swelling and pain in right little toe after cutting toe

nails ( 1 week)

Fever ( 1 week)

Unconsciousness ( 1 day)

 


Diabetes mellitus history video

 

EXAMINATION
Patient unconscious, smell of acetone in breath; Respiration 40/min, deep and rapid

Dehydration ++, tongue dry and coated, eyes sunken.

Temp: 39.50oC (rectal)

Pulse: 110/min low volume

B.P.: 85/60 mmHg

Heart and lungs were normal

Liver 2cm below right costal margin

Ankle jerks absent

After the patient had recovered from unconsciousness, she was found to have diminished sensations below the ankle joint in the feet.

Right little toe was swollen, reddish blue in color, there is presence of pus in the swelling.

Dorsalis pedis (artery) on right foot could no be felt.

Other pulsations were normal.

 

 

INVESTIGATIONS

Biochemical

Urine: Specific gravity 1018

Sugar ++++

Albumin +

Acetone ++

Blood: Glucose- 520 mg% (normal 70-110)

Urea 50mg%- (normal 20-40mg%)

pH 1.10- (normal 7.35-7.45)

Bicarbonate- 19 mEq/L (normal 22-28mEq/L)

Serum (Na+ 130mEq/Liter (normal 136-445 mEq/Liter)

Serum K+ 3.6mEq/L (normal 3.5-5mEq/L)

 

DIAGNOSIS

Diabetes mellitus with ketoacidotic coma; peripheral neuropathy and vasculopathy; abscess in right little toe.

 

 

Electronic School of Medicine
Creator: Oluwole Ogunranti